AOA works 24/7 to keep optometry prioritized in ACA, AHCA debate

The FINANCIAL -- Legislation proposed to dismantle the Affordable Care Act (ACA) has cleared the first in a series of major hurdles—and the AOA is diligently working to ensure optometry's priorities continue unabated in any new health care law.

Following weeks of delay and controversy, the Republican-led U.S. House of Representatives unveiled its designs on ACA repeal and replace language this month. Known as the American Health Care Act (AHCA) of 2017, it would target elements of ACA, including the individual and employer mandates, and Medicaid expansion.

Lacking any formal introduction yet, the AHCA passed portioned reviews by the House Energy & Commerce, and Ways and Means committees on March 9. However, it has since met opposition from not only Democrats and health care groups, such as the American Medical Association, but also prominent Republicans, according to AOA.

The AOA has not taken a formal position on the bill, instead choosing to closely follow the legislative maneuvering underway that could result in legislation being significantly amended before it is reported to the full House and Senate, possibly either in late March or early April. But that doesn't mean AOA is waiting to act. Proactively, AOA President Andrea P. Thau, O.D., met with members of Congress on Capitol Hill to advance the profession's priorities, even as the House committees began considering portions of the AHCA language.

"The AOA is committed to working with congressional leaders and the administration to improve the current system," says Dr. Thau. "While we are still assessing the impact that the complete bill and potential committee-level amendments would have on our patients, we are pleased to see that the bill includes key provisions recognizing that expanded access to eye health and vision care through in-person, comprehensive eye examinations helps ensure early diagnosis of a range of threats to a patient's health, including diabetes, hypertension and stroke."

Despite lawmakers' differences regarding this current proposed legislation, AOA is committed to ensuring optometry's priority messages aren't lost in the fray, including:

Safeguarding doctors' of optometry full physician recognition and inclusion in physician-level programs;

Upholding existing laws that assure access to in-person, comprehensive eye examinations, including the health plan-based pediatric essential benefit and the ban on discrimination by ERISA and other plans against doctors of optometry on the basis of licensure;

Ceasing abusive, anti-doctor health and vision plan policies, as reflected by the provisions of the AOA and American Dental Association-backed, bipartisan Dental and Optometric Care Access Act.

Current AHCA language provides an early indication that the AOA's message to Congress is resonating-a provision of the draft bill seeks to guide states in designing new programs aimed at expanding access to preventive and primary care, specifically including "vision care services (whether preventive or medically necessary)."

The AOA also is taking a measured approach to the AHCA given that it's likely only the first component of the new administration's tack on health care, which may include administrative directives from the Department of Health and Human Services, and the anticipated development of any separate health care bills. Clarke Newman, O.D., AOA Federal Relations Committee chair, says AOA's mindful approach to the ACHA is similar to when Congress first deliberated passage of the ACA.

"We are monitoring and lobbying Congress on the AHCA, knowing that this issue is much bigger than us," Dr. Newman says. "Our goal is to advocate for the positions that are important for optometry and our patients, such as access, full recognition and inclusion of doctors of optometry, and protecting non-discrimination language. We'll continue our plans going forward to stop the abusive policies of vision care plans, and we'll continue to move the DOC Access Act forward."